Delta内窥镜技术与椎板开窗椎间盘切除术治疗腰椎椎间盘突出症  

Delta endoscopy and fenestration discectomy for lumbar disc herniation

作　　者：李政桦 尹锐 Li Zhenghua;Yin Rui(Department of Spinal Surgery Diagnosis and Treatment Center,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China)

机构地区：[1]恩施土家族苗族自治州中心医院脊柱外科诊疗中心,恩施445000

出　　处：《脊柱外科杂志》2022年第4期242-245,共4页Journal of Spinal Surgery

摘　　要：目的比较Delta内窥镜技术与椎板开窗椎间盘切除术(FD)治疗腰椎椎间盘突出症(LDH)的临床疗效。方法2019年7月—2020年6月收治L_(5)/S_(1)单节段LDH患者100例,其中50例采用Delta内窥镜技术治疗(Delta组),另50例采用FD治疗(FD组)。记录并比较2组手术时间,住院时间,术中出血量,术后并发症发生率,术前和术后1、6个月的腰腿痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI),术后6个月采用改良MacNab标准评价疗效。结果所有手术顺利完成,所有患者随访时间大于6个月。Delta组术中出血量少于FD组,手术时间、住院时间短于FD组,术后并发症发生率低于FD组,差异均有统计学意义(P<0.05)。2组术后1、6个月VAS评分及ODI较术前明显改善,且Delta组改善优于FD组,差异均有统计学意义(P<0.05)。术后6个月2组疗效优良率差异无统计学意义(P>0.05)。结论Delta内窥镜技术治疗LDH疗效与FD相当,且术中出血量更少、术后恢复更快、并发症发生率更低、疼痛感更轻。Objective To compare the clinical effect of Delta endoscopy and fenestration discectomy(FD)for lumbar disc herniation(LDH).Methods From July 2019 to June 2020,100 patients with L_(5)/S_(1) single-segment LDH were treated,including 50 cases treated with Delta endoscopy(Delta group)and 50 treated with FD(FD group).The operation time,hospital stay,intraoperative blood loss,incidence of postoperative complications,low back pain and leg pain visual analogue scale(VAS)scores and Oswestry disability index(ODI)before and 1,6 months after operation were recorded and compared between the 2 groups.The modified MacNab criteria was used to evaluate the excellent and good rate of therapentic effect at 6 months after operation.Results All the operations were successfully completed,and all the patients were followed up for more than 6 months.The intraoperative blood loss,operation time and hospital stay in Delta group were lower than thos e in FD group,and incidence of postoperative complications was lower than that in FD group,all with a statistical significance(P<0.05).Compared with those before surgery,VAS scores and ODI in both groups were significantly improved at 1,6 months after operation.The low back and leg pain VAS scores and ODI in Delta group were lower than those in FD group at 1,6 months after operation,all with a statistical significance(P<0.05).There was no significant difference in the excellent and good rate of therapentic effect between the 2 groups at 6 months after operation(P>0.05).Conclusion Delta endoscopy is as effective as FD in the treatment of LDH,with less intraoperative blood loss,faster postoperative recovery,lower incidence of complications and milder pain.

关 键 词：腰椎 椎间盘移位 内窥镜检查 椎间盘切除术 外科手术 微创性 

分 类 号：R681.533.1[医药卫生—骨科学]